I just got my MRI results (I had a special dynamic/kinetic MRI that detects ligamental tears done):

"you have a partial rupture of the interspinous ligament
at the L5-S1 level [I also have a bulge there]; this results in some degree of sagittal plane hypermobile intersegmental instability at this same level. . . this
dysfunctional intersegmental motion in turn causes some degree of
accelerated intersegmental degeneration because of the underlying internal
'auto' trauma occurring progressively over time...."

Doesn't recommend surgery. So, I asked some questions (below) and he said
see a treatment specialist. Well, my pain MD is running out of
options and wants to boot me to a neurosurgeon but I'm not a candidate for
surgery so I am basically Screwed. There are a few articles on ligament
ruptures recently indicating that this may be a major cause of back pain and
lead to disc herniation (duh) but no discussion of treatment options.
Basically, according to his report: wait until your spine really crumbles
and you are screaming for surgery.

I'm trying prolotherapy now, which has helped SI, iliolumbar but not the lumbosacral (L5-S1) area.

It is finally good to know what is wrong with my back. Before I meet with my
M.*. next week I had a few quick questions, if you don't mind. I UNDERSTAND
that any advice you give is _unofficial_ and that I should consult my M.*.
before taking any further medical action. Thanks again. -- (real name removed)

Jon,
Why are you "not" a candidate for surgery? After going from MD to MD, chiropractors, accupuncture, pain management,etc. I referred myself to a spine doctor. My back couldn't take anymore and neither could I. A month later I had a fusion. I guess you could say I was screaming for relief. Down on my knees to get out of bed and 15 minutes or so to get off the floor. It was horrible with electric shock pain. My disc had torn and healed over so many times that it was calcified when the doctor took it out in pieces. Tears are painful in that the center of the disc leaks acid type "crap" that irritates the nerves.
What you should avoid is things that cause your back to flare up. If it hurts, don't do it. My opinion of steroid shots is that they are temporary and mask the real cause of pain. Depending on how bad your back pain is and if it is tolerable or not, that would be the deciding factor for surgery. Instability and herniated discs usually point to fusion but if you are not a candidate, I don't know. I feel for you, back pain sucks!
Take care,
Elaine

My pain is "tolerable" but the back pain hit me at 39 and I don't want to drag through a "tolerable" existence for the next ____ years I have left on this planet. Haven't had a fun, enjoyable, pain-free day in 18 months and doubt I'll ever have one again. BUT...my pain isn't nerve-related and I can DRAG myself through each day only because I have a family to live for and support.

I'm reminded of the old Rolling STones tune, which rings true for those of us caught in never-ending back pain: "What a drag it is getting old." Now I understand more fully the Catholic concept of purgatory!

Jon,
What type of pain do you have if it is not nerve related? Why do they say you are not a candidate for surgery? I have had two fusions, (so far) My back is a mess due to a bad car wreck. I think what they fixed did fine but more discs are herniated and causing me problems. The L4 disc was bulging when they did the first fusion on L5. The pressure caused L4 to totally rupture which resulted in another fusion two years later. I just had the last surgery 11 months ago. The L3 has a fissure but no symptoms, from T10 To L1 are all herniated. These are what give me problems but as far as the fusions, I am not sorry I had them done.
There comes a time when you know it is time for surgery and believe me, I was there.
Take care,
Elaine

Originally, it was stabbing "hot" pain from a bulging disc that referred out to my entire lower back but the primary symptoms for the longest time have been extreme stiffness and a deep ache at the base of my spine. I have to change position constantly because prolonged sitting, standing, etc. worsen the pain. The pain has receded to the left-center part of my lower lumbosacral region but it is continuous but "tolerable," as the doctors say.

Origin of pain? Probably ruptured ligaments that led to bulging disc (L5-S1) that then receded but now I probably have DDD. This is all guess work. My pain is, as they say, "somatic" or nociceptive (sp?), not radicular which means they don't usually operate partly because they can't determine the origin of the pain. Besides, there isn't much that can be done for ligament ruptures, or so they say.... Damn doctors. Excuse my language.